Baxter Life Care Limited

Baxter Life Care Limited is a domiciliary care agency providing personal care to people in their own homes. At the time of our inspection there were 45 people using the service. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided.

People’s experience of using this service and what we found

The service was not always safe. We found care records were not always accurate. Where risks to people were identified recorded documentation to lessen the risk was, at times, conflicting. We found concerns with medicine records and the management of people’s medicines. We found there was not a structured, systematic, effective approach to assess and monitor the service to identify shortfalls and drive improvements.

We have made recommendation about oversight of feedback from people who use the service.

The provider followed safe systems for staff recruitment. We received consistent feedback from people who felt safe with the care staff. One person told us, “The company gives me good support and we have a laugh and a joke." People told us they received visits from care staff who they were familiar with.

People we spoke with were complimentary about the service. There was a positive staff culture at the service and staff were happy in their roles. One staff member told us, “This is the best community care company I have worked for.”

We found the management team receptive to feedback and keen to improve the service. The registered manager and provider worked with us in a positive manner and the information we requested were received in a timely manner.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk.

Rating at last inspection and update

The last rating for this service was requires improvement (published 14 September 2021). The service remains rated requires improvement. This service has been rated requires improvement for the last two consecutive inspections.

The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found the provider remained in breach of regulations.

At our last inspection we recommended that the provider reviewed their risk management systems and documentation. At this inspection we found this recommendation had not been completed. We found care documentation did not include all the information staff required to lesson risks to people.

Why we inspected

We carried out an unannounced focussed inspection of this service on 14 September 2021. A breach of legal requirements was found. The provider completed an action plan after the last inspection to show what they would do and by when to improve governance.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has remained Requires Improvement. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Baxter Life Care Limited on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified a continued breach in relation to good governance at this inspection.

Full information about CQC's regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Baxter Life Care Limited provides personal care to people in their own homes, in and around the Blackpool area. Not everyone who used the service received personal care. CQC only inspects where people receive a regulated activity. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided. At the time of our inspection 21 people were receiving personal care.

People’s experience of using this service and what we found

We received mixed feedback about staffing and the organisation of staff. We made a recommendation around consistent risk management. Policies and systems were in place to help make sure medicines were managed safely. We recommend further developing these to ensure medicines records and audits are accurate and comprehensive. The provider learnt from incidents and shared learning to improve the safety of the service. However, we found some incidents had not been acted upon in a timely manner. People felt safe and were protected against the risk of abuse. The provider had robust infection prevention and control procedures to protect people from cross infection. Staff were recruited safely and there were enough of them to meet people’s needs.

The service was not consistently well-led. We found shortfalls in the provider’s systems to assess, monitor and improve the service. The accuracy and quality of records was inconsistent. This could have compromised the safety and quality of the service.

The provider and new manager were receptive and keen to make improvements. Following our inspection, they acted immediately to address the shortfalls in standards we identified.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 19 December 2018).

Why we inspected

We received concerns in relation to staffing and governance of the service. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection.

You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Baxter Life Care Ltd on our website at www.cqc.org.uk.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation to good governance and records at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

People’s experience of using this service:

The service had systems to ensure risks were managed and people were kept safe. People received effective care from a well-supported and trained staff team. Staff understood the importance of providing person-centred care and treated everyone as individuals, respecting their abilities and promoting independence. Staff had built positive caring relationships with people they supported and their families. People received personalised care that was responsive to their needs and preferences. Staff liaised with other health care professionals to ensure people's safety and meet their health needs. Where staff noted a concern they quickly involved healthcare professionals, to achieve positive outcomes for people and reduce any risks. We received consistently positive feedback about how the service was managed.

More information is in the full report.

Rating at last inspection: This was the first time the service had been inspected since registering as a new location.

Why we inspected: This was a scheduled inspection to assess the quality of the service during their first year operating from the new location.

Follow up: The next scheduled inspection will be in keeping with the overall rating. We will continue to monitor information we receive from and about the service.